24.11 Medical and Psychological Services Billing

Payment for medical and psychological services must be authorized by CRS program staff members and must support the rehabilitation services and goals.

Medical and psychological services, including medical goods and supplies, are purchased using Maximum Affordable Payment Schedule (MAPS) coding and pricing. MAPS codes establish the maximum payment that can be authorized for these services. Staff should work closely with the provider to ensure payment corresponds to the correct MAPS code(s). Treatment decisions and accurate identification of the applicable MAPS code are the responsibility of the consumer's healthcare provider and designated program staff or consultants.

The CRS program utilizes the Medical Services Required Practices Handbook to provide guidance to the medical services coordinator, medical services technician, counselor, and rehabilitation services technician who coordinate medical services for consumers.

Fees in excess of the contracted fee for a specific service or for MAPS fees are not authorized; managers may not authorize an exception.